PREVALENCE OF RISK FACTORS AND COMORBID CONDITIONS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS
Introduction: COPD is associated with several risk factors and co morbid conditions. Dealing
with co-morbidity needs a patient centered approach, rather than a disease oriented approach7.
The present study was conducted to study risk factors and co morbid conditions of COPD
Material and Methods: The present study was conducted in department of Pulmonary
Medicine at Shri Ram Murti Smarak Institute of Medical Sciences with respiratory complaints
over a period of one and a half year. The data was collected in terms of demographic features,
anthropometric measurements and various risk factors and co morbid conditions. Spirometry
was performed thrice and the largest values of both FVC and FEV1 were noted from three
technically satisfactory curves. COPD severity was classified based on Spirometric
assessment according to the GOLD classification. Categorical variables were analyzed using
proportions and percentages.
Results: In a study of 201 cases that were diagnosed as a case of COPD the mean age was 62.6
years and male predominance. Majority of the patients had sedentary life style and were from
poor class. The co morbid conditions anemia, cardiac, hypertension, diabetes mellitus, lipid
disorders, thyroid disorders, osteoporosis, psychiatric illness, ophthalmic defects and
obstructive sleep apnea was found in 43.8%, 52.2%, 65.2%, 52.2%, 51.7%, 64.7%, 72.1%,
66.7%, 28.9% and 54.2% respectively.
Conclusion: Co morbidities should be taken into consideration while prescribing multiple
drugs so that side effects and interactions of drug can be monitored and quality of life can be
variations in prevalence and under diagnosis of
COPD: results of the IBERPOC multicentre
epidemiological study. Chest 2000;118:981-89
2. Life in the 21st century: a vision for all. Geneva,
Switzerland: World Health Organization,1998
3. Mannino DM, Watt G, Hole D. The natural history of
chronic obstructive pulmonary disease. Eur Respir J
4. Sin DD, Man SF. Why are patients with chronic
obstructive pulmonary disease at increased risk of
cardiovascular diseases? The potential role of
systemic inflammation in chronic obstructive
pulmonary disease. Circulation 2003;107:1514-9
5. Janson C, Marks G, Buist S, Gnatiuc L, Gislason T.
The impact of COPD on health status: findings from
the BOLD study. Eur Respir J 2013;42(6):1472-83
6. GOLD report 2015 – Global strategy for the diagnosis,
management, and prevention of chronic obstructive
p u l m o n a r y d i s e a s e . Av a i l a b l e f r o m :
7. The Seventh Report of the Joint National Committee
on Prevention, Detection, Evaluation, and Treatment
of High Blood Pressure. Bethesda, Maryland, USA:
National Institutes of Health; 2004 Aug. Publication
8. Diagnosing Diabetes and Learning about prediabetes:
American Diabetes Association. Available from:
h t t p : / / w w w . d i a b e t e s . o r g / d i a b e t e s -
9. Haemoglobin concentrations for the diagnosis of
anaemia and assessment of severity. Geneva,
Switzerland: Department of Nutrition for Health and
Development (NHD), World Health Organization;
2010. Report No.: WHO/NMH/NHD/MNM/11.1
10. UK Guidelines for the Use of Thyroid Function Tests.
British Thyroid Foundation. Available from:
11. WHO Scientific Group on the Prevention and
Management of Osteoporosis (2000: Geneva,
S w i t z e r l a n d ) . A v a i l a b l e f r o m :
12. Hamilton M. The assessment of anxiety states by
rating. Br J Med Psychol 1959; 32:50–5
13. Hamilton, M Rating depressive patients. J Clin
14. Ruehland WR, Rochford PD, O Donoghue FJ, Pierce
RJ. Sleep 2009;32(2):150-7
15. Barnes PJ, Celli BR. Systemic manifestations and
comorbidities of COPD. Eur Respir J 2009;33:1165-
16. Soriano JB, Visick GT, Muellerova H, Payvandi N.
Patterns of comorbidities in newly diagnosed COPD
and asthma in primary care. Chest 2005;128:2099-
17. Mannino DM, Thorn D, Swensen A, Holguin F.
Prevalence and outcomes of diabetes, hypertension
and cardiovascular disease in COPD. Eur Respir J
18. Sin DD, Anthonisen NR, Soriano JB, Agusti AG.
Mortality in COPD: Role of comorbidities. Eur Respir
J 2006; 28:1245-57
19. Almagro P, Cabrera FJ, Diez J, Boixeda R. Working
Group on COPD, Spanish Society of Internal
Medicine. Comorbidities and short-term prognosis in
patients hospitalized for acute exacerbation of COPD:
the EPOC en Servicios de medicina interna (ESMI)
study. Chest Nov 2012;142(5):1126-33.
20. Miller J, Edwards LD, Agusti A, Bakke P. Evaluation
of COPD Longitudinally to Identify Predictive
Surrogate Endpoints (ECLIPSE) Investigators.
Comorbidity, systemic inflammation and outcomes in
the ECLIPSE cohort. Respir Med 2013; 107(9):1376-
21. Casanova LC, Sustaeta JME, Luján RG, Lozano IA.
Prevalence of anemia associated with chronic
obstructive pulmonary disease. Study of associated
variables. Arch Bronco pneumol 2013;49(9):383-87
22. Silverberg DS, Mor R, Weu MT, Schwartz D. Anemia
and iron deficiency in COPD patients: prevalence and
the effects of correction of the anemia with
erythropoiesis stimulating agents and intravenous
iron. BMC Pul Med 2014;14-24
23. Corlateanu A, Montanari G, Pylchenko S, Botnaru V,
Sircu V. Impact of Anemia on Functional State of
Patients with Chronic Obstructive Pulmonary
Disease. Alveolus 2014;2(1):3-11
24. Bellocchia M, Masoero M, Ciuffreda A, Croce S.
Predictors of cardiovascular disease in asthma and
chronic obstructive pulmonary disease. Multidiscip
Respir Med 2013;8(1):58
25. Ramos PDL, Alonso JLI, Moro JMRG, Frances JF,
Lozano PV, Bellón-Cano JM. Chronic obstructive
pulmonary disease as a cardiovascular risk factor.
Results of a case–control study (CONSISTE study).
Int J Chron Obstruct Pulmon Dis 2012; 7: 679-86
26. Skyba P, Joppa P, Orolin M, Tkacova R. Blood
pressure and heart rate variability response to
noninvasive ventilation in patients with exacerbations
of chronic obstructive pulmonary disease. Physiol Res
27. Chandy D, Aronow WS, Banach M. Current
perspectives on treatment of hypertensive patients
with chronic obstructive pulmonary disease.
Integrated Blood Pressure Control 2013;6:101-09
28. Mishra GP, Dhamgaye TM, Tayade BO, Amol BF.
Study of pulmonary function tests in diabetics with
COPD or asthma. Applied Cardiopulmonary
29. Hersh CP, Make BJ, Lynch DA, Barr RG. Nonemphysematous
chronic obstructive pulmonary
disease is associated with diabetes mellitus. BMC Pul
30. Mirrakhimov AE. Chronic obstructive pulmonary
disease and glucose metabolism: a bitter sweet
symphony. Cardiovascular Diabetology 2012;11:132
31. Barr RG, Dr PH, Celli BR, Mannino DM.
Comorbidities, Patient Knowledge, and Disease
Management in a National Sample of Patients with
COPD: Am J Med 2009;122(4):348-55
32. Aras G, Kanmaz D, Purisa S, Kadakal F. Are thyroid
functions changing in patients with exacerbated
COPD? Thyroid functions in exacerbated COPD.
33. Gupta M, Vardey SK, Joshi N, Dixit R. Evaluation of
thyroid dysfunction in chronic obstructive pulmonary
disease. Biomedical Research 2013;24(1):110-13
34. Prakash R, Harish M, Suryanarayana V, Priya MP.
Evaluation of Thyroid Functions in Chronic
Obstructive Pulmonary Disease. World J Med Sci
35. Rittayamai N, Chuaychoo B, Sriwijitkamol A.
Prevalence of Osteoporosis and Osteopenia in Thai
COPD Patients. J Med Assoc Thai 2012; 95:8
36. Naghshin R, Javadzadeh A, Mousavi SAJ, Adeli SH.
Comparison of the osteoporosis between male
smokers with and without chronic obstructive
pulmonary disease: Tanaffos 2004;3(9):13-8
37. Motiani B, Haidri FR, Rizvi N. Frequency of
depression in chronic obstructive pulmonary disease
(COPD) patients. Pak J Med Sci 2011;27(5):1112-15
38. Tselebis A, Bratis D, Kosmas E, Harikiopoulou M.
Psychological symptom patterns and vital exhaustion
in outpatients with chronic obstructive pulmonary
disease. Ann Gen Psychiatry 2011;10:32
39. Wagena EJ, Arrindell WA, Wouters EFM, Schayck
CPV. Are patients with COPD psychologically
distressed? Eur Respir J 2005;26:242-48
40. Rai DK, Upadhyaya SK, Sharma A, Kuldeep K.
Prevalence of Depression in Chronic respiratory
diseases: IOSR Journal of Dental and Medical
41. Aggelakas AS. Chronic obstructive pulmonary
disease and sleep apnea: The Overlap syndrome.
42. Zamarron C, Paz VG, Morete E, Matías FC.
Association of chronic obstructive pulmonary disease
and obstructive sleep apnea consequences.
International Journal of COPD 2008;3(4):671-82
43. EEzzie BMM. Update on obstructive sleep apnea and
its relation to COPD. International Journal of COPD